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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Microvascular Coronary Dysfunction-an Overview.

Sahar Naderi1

  • 1Division of Cardiology, Kaiser Permanente Northern California, San Francisco, CA, USA. Sahar.Naderi@kp.org.

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|February 1, 2018
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Summary

Microvascular coronary dysfunction (MCD) causes cardiac chest pain, especially in women. Research is advancing diagnostic and treatment strategies for this condition, though much remains unknown.

Keywords:
Microvascular diseaseMicrovascular dysfunctionWomen’s heart disease

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Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Imaging

Background:

  • Microvascular coronary dysfunction (MCD) is an increasingly recognized cause of cardiac chest pain, particularly in women.
  • It involves dysfunction of the heart's small coronary vessels without significant blockages in the larger epicardial arteries.
  • The Women's Ischemia Syndrome Evaluation (WISE) cohort has been instrumental in advancing the study of MCD.

Purpose of the Study:

  • To review current data on the epidemiology, pathophysiology, diagnosis, and management of microvascular coronary dysfunction (MCD).
  • To highlight advancements in diagnostic techniques and treatment approaches for MCD.
  • To underscore the growing recognition of MCD as a cause of ischemic symptoms.

Main Methods:

  • Review of available epidemiological data.
  • Analysis of pathophysiological mechanisms, including endothelial-dependent and independent factors.
  • Evaluation of current diagnostic techniques (invasive and noninvasive).
  • Assessment of management strategies for MCD.

Main Results:

  • MCD is a significant cause of cardiac chest pain, with a notable prevalence in women.
  • New diagnostic tools are improving the identification and understanding of MCD.
  • While progress has been made, significant knowledge gaps regarding MCD persist.

Conclusions:

  • Microvascular coronary dysfunction is a critical clinical entity requiring further investigation.
  • Enhanced diagnostic capabilities are improving patient awareness and treatment options.
  • Continued research is essential to fully elucidate the complexities of MCD and optimize patient care.